Cantwell Introduces Legislation to Expand Basic Health Program to Cover More People at Lower Cost

Basic Health Program (BHP) would make more affordable health care available for more than 162,000 Washingtonians; Legislation would expand BHP eligibility, help states develop and implement new programs to cover uninsured, people struggling to afford insurance

WASHINGTON, D.C.  – Today, U.S. Senator Maria Cantwell (D-WA) introduced legislation to bring lower-cost, high-quality health insurance to more Americans in the individual health insurance market by expanding the Basic Health Program (BHP), an option through the Affordable Care Act that empowers states to use federal funding to negotiate directly with managed care plans – essentially a state-based public health care option. Expanding BHP would significantly lower health care premiums and deductibles for low-income working individuals who are ineligible for Medicaid and often struggle to afford private health insurance.

“If you buy in bulk, you should get a discount, and that applies to negotiated rates for health insurance and prescription drugs. Right now there are more than 162,000 Washingtonians missing out on more affordable health insurance. By making health insurance more affordable with the Basic Health Plan, we can drive down rates and cover more people,” said Cantwell.

Cantwell’s legislation, the Basic Health Program Expansion Act of 2018, would offer states the option to expand eligibility for Basic Health Programs to the same income level as their Children’s Health Insurance Program (CHIP) eligibility line, which varies by state. The legislation would also authorize states to use federal BHP money for up to one year to develop and implement a new BHP program, helping to overcome a potential barrier to adoption of the program.

According to a 2012 report by the Health Policy Center at The Urban Institute, more than 160,000 Washington state residents would be eligible for coverage under a Basic Health Plan. With Cantwell’s bill to expand BHP, this option could make coverage available to a majority of the individual insurance market in many states.

“The Basic Health Program Expansion Act will make it easier for other states to follow the lead of Minnesota and New York who have successfully adopted the Basic Health Plan to reduce costs for their residents and expand access to affordable health care,” said Janet Varon, executive director of Northwest Health Law Advocates. “We applaud Senator Cantwell's efforts to encourage states to offer affordable health coverage to consumers who make too much for Medicaid but for whom private health insurance is often out of reach.”

Two states – New York and Minnesota – have already utilized the BHP with tremendous success: New Yorkers in the state’s BHP save an average of more than $1,000 in health care costs each year, and Minnesotans have saved as much as $552 per year in health care costs, compared to what they would otherwise pay. The program has also helped New York provide coverage to more than 738,000 people and save the state more than $1 billion in budget costs.

“New York’s Essential Plan is wildly popular and already provides high quality, no-deductible coverage to roughly 735,000 New Yorkers at a price they can afford. This option would be a Godsend to those New Yorkers seeking a low-cost public alternative through the Marketplace,” said Elisabeth Benjamin, Vice President of Health Initiatives at the Community Service Society of New York and a co-founder of Health Care for All New York. “The Community Service Society enthusiastically supports this important piece of legislation that would radically improve the affordability and quality of coverage for working New Yorkers.”

A 2016 study from the Kaiser Family Foundation and Urban Institute found that health insurance enrollment in New York increased by 42 percent after it switched from the Exchange to its Basic Health Plan (known as the Essential Plan) for individuals between 138 and 200 percent of the federal poverty level. The study also found that the Basic Health Plan did not appear to destabilize the Exchange or the individual insurance market in either New York or Minnesota.

“The Basic Health Program gives states a common-sense and proven way to offer lower-cost, comprehensive, health insurance to more people,” said Shawn Gremminger, Senior Director of Federal Relations at Families USA. “Minnesota and New York have used this option to provide high-quality, affordable coverage to hundreds of thousands of low-wage working families. Unlike the sham insurance plans being pushed by the Trump Administration, which can discriminate against people with pre-existing conditions and charge outrageous prices, the Basic Health Program offers real insurance that covers all essential health benefits, retains all patient protections under current law, and lets states make coverage more affordable. Families USA strongly supports the Basic Health Program Expansion Act, which gives states flexibility to offer basic health plan coverage to more people.”

The Basic Health Program provision in the Affordable Care Act is modeled on Washington state’s highly successful Basic Health Plan, a state-funded health insurance program that became the first of its kind in the nation when late Governor Booth Gardner signed it into law in 1987. The Basic Health Plan grew from a pilot program serving residents of King and Spokane Counties into a statewide program serving tens of thousands of residents. The plan was suspended in 2014 due to budget constraints.

In May of 2016, Senator Cantwell and then-Rep. Jim McDermott sent a letter to Governor Jay Inslee, Majority Leader Mark Schoesler, Democratic Leader Sharon Nelson, Speaker Frank Chopp, and Minority Leader Dan Kristiansen, urging them to make the Basic Health Plan available to Washingtonians.